CA2536421A1 - A device for carrying out a peritoneal dialysis treatment - Google Patents
A device for carrying out a peritoneal dialysis treatment Download PDFInfo
- Publication number
- CA2536421A1 CA2536421A1 CA002536421A CA2536421A CA2536421A1 CA 2536421 A1 CA2536421 A1 CA 2536421A1 CA 002536421 A CA002536421 A CA 002536421A CA 2536421 A CA2536421 A CA 2536421A CA 2536421 A1 CA2536421 A1 CA 2536421A1
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- CA
- Canada
- Prior art keywords
- volume
- dialysis fluid
- fill
- abdominal cavity
- period
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/28—Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1601—Control or regulation
- A61M1/1613—Profiling or modelling of patient or predicted treatment evolution or outcome
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/28—Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
- A61M1/281—Instillation other than by gravity
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/28—Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
- A61M1/282—Operational modes
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- Health & Medical Sciences (AREA)
- Urology & Nephrology (AREA)
- Heart & Thoracic Surgery (AREA)
- Emergency Medicine (AREA)
- Anesthesiology (AREA)
- Engineering & Computer Science (AREA)
- Vascular Medicine (AREA)
- Biomedical Technology (AREA)
- Hematology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- External Artificial Organs (AREA)
Abstract
The invention concerns a device and a method for a peritoneal dialysis treatment in several cycles. A cycler (1) controlled by a processor (31) fills the abdominal cavity with dialysis fluid, and drains the abdominal cavity. A
sensor (37) senses a variable related to the draining of the dialysis fluid.
The draining is interrupted when the variable reaches a breakpoint at which the variable is radically changed, thereby leaving the residual volume.
sensor (37) senses a variable related to the draining of the dialysis fluid.
The draining is interrupted when the variable reaches a breakpoint at which the variable is radically changed, thereby leaving the residual volume.
Claims (38)
1. A device for carrying out a tidal peritoneal dialysis treatment of a patient in a plurality of cycles, each cycle including a fill period (F), a dwell period (Dw) and drain period (Dr), the device including:
a processor (31);
a cycler (1) connected to the processor and adapted to fill the abdominal cavity of the patient with dialysis fluid, and to drain the abdominal cavity; and a sensor (37) connected to the processor and adapted to sense during the draining a variable related to the draining of the dialysis fluid from the abdominal cavity;
wherein the processor (31) is adapted to initiate interruption of the draining, at least for most of the cycles of the treatment, when the variable reaches a breakpoint at which the variable is radically changed, thereby leaving a residual volume of dialysis fluid in the abdominal cavity.
a processor (31);
a cycler (1) connected to the processor and adapted to fill the abdominal cavity of the patient with dialysis fluid, and to drain the abdominal cavity; and a sensor (37) connected to the processor and adapted to sense during the draining a variable related to the draining of the dialysis fluid from the abdominal cavity;
wherein the processor (31) is adapted to initiate interruption of the draining, at least for most of the cycles of the treatment, when the variable reaches a breakpoint at which the variable is radically changed, thereby leaving a residual volume of dialysis fluid in the abdominal cavity.
2. A device according to claim 1, including means (31,32,35,36) for determining a first parameter concerning a desired target volume of the dialysis fluid to be contained in an abdominal cavity of the patient after each fill period of the treatment.
3. A device according to any one of claims 1 and 2, including means (31,32,35,36) for determining a second parameter concerning a total volume of a dialysis fluid to be used during the remaining part of the treatment.
4. A device according to any one of the preceding claims, including means (31,32,35,36) for determining a third parameter concerning a total length of time of the remaining part of the treatment.
5. A device according to any one of the preceding claims, including means (31,32,35,36) for determining a fourth parameter concerning a residual volume of dialysis fluid in the abdominal cavity after the drain period.
6. A device according to claims 2 - 5, wherein the processor (31) is adapted to calculate for the next one of said cycles by means of the parameters a fill volume (VF) of the dialysis fluid and a fill/dwell time including the time of the fill period and the dwell period.
7. A device according to claim 6, wherein the cycler (1) is adapted to fill the abdominal cavity of the patient with the calculated fill volume of the dialysis fluid until the target volume is reached, and to drain the abdominal cavity after the calculated fill/dwell time.
8. A device according to any one of claims 6 and 7, wherein the processor is adapted to set the dwell period to a constant time value for substantially all cycles of the treatment at least for certain patients to be treated.
9. A device according to any one of claims 5 - 8, including means (31,32,35,36) for determining an initial, fifth parameter concerning an expected ultrafiltration volume, wherein the processor (31) is adapted to considered the fifth parameter in the calculation of the fill volume (VF) of the dialysis fluid.
10. A device according to any one of claims 6 to 9, wherein the processor (31) is adapted to calculate also a number of said cycles to be performed during the remaining part of the treatment.
11. A device according to any one of claims 6 to 10, wherein processor (31) is adapted to make a relatively small adjustment of the target volume determined by the first means for the cycles following after the first cycle.
12. A device according to any one of the preceding claims, wherein said variable includes the flow rate of the dialysis fluid during the drain period.
13. A device according to any one of the preceding claims, wherein said variable includes a pressure in the abdominal cavity of the patient during the drain period.
14. A device according to at least claim 9, wherein the sensor (37) is adapted to sense a drain volume of the drained dialysis fluid after the drain period and wherein the processor (31) is adapted to calculate the residual volume by means of the drain volume, the expected ultrafiltration volume and the fill volume, and to determine a trend of the residual volume after at least two cycles.
15. A device according to claim 14, wherein the processor (31) is adapted to adjust the expected ultrafiltration volume if the trend exhibits an increasing or decreasing value of the residual volume and if said value exceeds a predetermined first limit value.
16. A device according to any one of claims 14 and 15, wherein the cycler (1) is adapted to drain, during a following cycle, the abdominal cavity completely so that the residual volume is substantially zero if the trend exhibits an increasing or decreasing value of the residual volume and if said value exceeds a predetermined second limit value, and wherein the processor (31) is adapted to calculate a new expected ultrafiltration volume based on the drain volume after the complete draining.
17. A device according to any one of the preceding claims, wherein the sensor (37) is adapted to detect an initial value of said variable at the beginning of the drain period and a critical value of said variable, wherein the breakpoint is reached when the variable reaches the critical value.
18. A device for carrying out a tidal peritoneal dialysis treatment of a patient in a plurality of cycles, each cycle including a fill period (F), a dwell period (Dw) and drain period (Dr), the device including:
means (31,32,35,36) for determining a first parameter concerning a desired target volume of the dialysis fluid to be contained in an abdominal cavity of the patient after each fill period of the treatment;
means (31,32,35,36) for determining a second parameter concerning a total volume of a dialysis fluid to be used during the remaining part of the treatment;
means (31,32,35,36) for determining a third parameter concerning a total length of time of the remaining part of the treatment;
means (31,32,35,36) for determining a fourth parameter concerning a residual volume of dialysis fluid in the abdominal cavity after the drain period;
a processor (31) adapted to calculate for the next one of said cycles by means of the parameters a fill volume (VF) of the dialysis fluid and a fill/dwell time including the time of the fill period and the dwell period;
a cycler (1) connected to the processor and adapted to fill the abdominal cavity of the patient with the calculated fill volume of the dialysis fluid until the target volume is reached, and to drain the abdominal cavity after the calculated fill/dwell time; and a sensor (37) connected to the processor and adapted to sense during the draining a variable related to the draining of the dialysis fluid from the abdominal cavity;
wherein the processor (31) is adapted to initiate interruption of the draining when the variable reaches a breakpoint at which the variable is radically changed, thereby leaving a residual volume of dialysis fluid in the abdominal cavity.
means (31,32,35,36) for determining a first parameter concerning a desired target volume of the dialysis fluid to be contained in an abdominal cavity of the patient after each fill period of the treatment;
means (31,32,35,36) for determining a second parameter concerning a total volume of a dialysis fluid to be used during the remaining part of the treatment;
means (31,32,35,36) for determining a third parameter concerning a total length of time of the remaining part of the treatment;
means (31,32,35,36) for determining a fourth parameter concerning a residual volume of dialysis fluid in the abdominal cavity after the drain period;
a processor (31) adapted to calculate for the next one of said cycles by means of the parameters a fill volume (VF) of the dialysis fluid and a fill/dwell time including the time of the fill period and the dwell period;
a cycler (1) connected to the processor and adapted to fill the abdominal cavity of the patient with the calculated fill volume of the dialysis fluid until the target volume is reached, and to drain the abdominal cavity after the calculated fill/dwell time; and a sensor (37) connected to the processor and adapted to sense during the draining a variable related to the draining of the dialysis fluid from the abdominal cavity;
wherein the processor (31) is adapted to initiate interruption of the draining when the variable reaches a breakpoint at which the variable is radically changed, thereby leaving a residual volume of dialysis fluid in the abdominal cavity.
19. A method for carrying out a tidal peritoneal dialysis treatment of a patient in a plurality of cycles, each cycle including a fill period, a dwell period and drain period, the method including, for substantially all cycles, the steps of:
filling the abdominal cavity of the patient with a fill volume of dialysis fluid;
draining the abdominal cavity;
sensing during the draining a variable related to the draining of the dialysis fluid leaving the abdominal cavity;
interrupting the draining when, at least for most of the cycles of the treatment, the variable reaches a breakpoint at which the variable is radically changed; and leaving a residual volume of dialysis fluid in the abdominal cavity.
filling the abdominal cavity of the patient with a fill volume of dialysis fluid;
draining the abdominal cavity;
sensing during the draining a variable related to the draining of the dialysis fluid leaving the abdominal cavity;
interrupting the draining when, at least for most of the cycles of the treatment, the variable reaches a breakpoint at which the variable is radically changed; and leaving a residual volume of dialysis fluid in the abdominal cavity.
20. A method according to claim 19, including the further step of:
determining a first parameter concerning a desired target volume of the dialysis fluid to be contained in an abdominal cavity of the patient after each fill period of the treatment.
determining a first parameter concerning a desired target volume of the dialysis fluid to be contained in an abdominal cavity of the patient after each fill period of the treatment.
21. A method according to any one of claims 19 and 20, including the further step of:
determining a second parameter concerning a total volume of a dialysis fluid to be used during a remaining part of the treatment.
determining a second parameter concerning a total volume of a dialysis fluid to be used during a remaining part of the treatment.
22. A method according to any one of claims 19 to 21, including the further step of:
determining a third parameter concerning a total length of time of the remaining part of the treatment.
determining a third parameter concerning a total length of time of the remaining part of the treatment.
23. A method according to any one of claims 19 to 22, including the further step of:
determining a fourth parameter concerning a residual volume of dialysis fluid in the abdominal cavity after the drain period.
determining a fourth parameter concerning a residual volume of dialysis fluid in the abdominal cavity after the drain period.
24. A method according to claims 19 to 23, including the further step of:
calculating for the next one of said cycles by means of the parameters a fill volume of the dialysis fluid and a fill/dwell time including the time of the fill period and the dwell period.
calculating for the next one of said cycles by means of the parameters a fill volume of the dialysis fluid and a fill/dwell time including the time of the fill period and the dwell period.
25. A method according to claim 24, wherein the filling step includes filling the abdominal cavity of the patient with the calculated fill volume of the dialysis fluid until the target volume is reached, and wherein the draining step includes draining the abdominal cavity after the calculated fill/dwell time.
26. A method according to any one of claims 24 and 25, wherein the calculating step permits the dwell period to be set to a constant time value for substantially all cycles of the treatment at least for certain patients to be treated.
27. A method according to any one of claims 24 to 26, including the further step of:
determining as an initial measure a fifth parameter concerning an expected ultrafiltration volume, wherein the fifth parameter is also considered in the step of calculating the fill volume of the dialysis fluid.
determining as an initial measure a fifth parameter concerning an expected ultrafiltration volume, wherein the fifth parameter is also considered in the step of calculating the fill volume of the dialysis fluid.
28. A method according to any one of claims 24 to 27, wherein the calculating step also includes calculating of a number of said cycles to be performed during the remaining part of the treatment.
29. A method according to any one of claims 24 to 28, wherein the step of determining the first parameter includes a relatively small adjustment of the target volume for the cycles following after the first cycle.
30. A method according to any one of claims 19 to 29, wherein said variable includes the flow rate of the dialysis fluid during the drain period.
31. A method according to any one of claims 19 to 30, wherein said variable includes a pressure in the abdominal cavity of the patient during the drain period.
32. A method according to claim 27 and possibly any one of claims 28 to 31, including the further steps of:
sensing a drain volume of the drained dialysis fluid after the drain period;
calculating the residual volume by means of the drain volume, the expected ultrafiltration volume and the fill volume; and determining a trend of the residual volume after at least two cycles.
sensing a drain volume of the drained dialysis fluid after the drain period;
calculating the residual volume by means of the drain volume, the expected ultrafiltration volume and the fill volume; and determining a trend of the residual volume after at least two cycles.
33. A method according to claim 32, including the further step of:
adjusting the expected ultrafiltration volume if the trend exhibits an increasing or decreasing value of the residual volume and if said value exceeds a predetermined first limit value.
adjusting the expected ultrafiltration volume if the trend exhibits an increasing or decreasing value of the residual volume and if said value exceeds a predetermined first limit value.
34. A method according to any one of claims 32 and 33, including the further step of:
draining, during a following cycle, the abdominal cavity completely so that the residual volume is substantially zero if the trend exhibits an increasing or decreasing value of the residual volume and if said value exceeds a predetermined second limit value, and calculating a new expected ultrafiltration volume based on the drain volume after the complete draining.
draining, during a following cycle, the abdominal cavity completely so that the residual volume is substantially zero if the trend exhibits an increasing or decreasing value of the residual volume and if said value exceeds a predetermined second limit value, and calculating a new expected ultrafiltration volume based on the drain volume after the complete draining.
35. A method according to any one of claims 19 to 34, wherein the sensing step includes detecting an initial value of said variable at the beginning of the draining step and a critical value of said variable, wherein the breakpoint is reached when the variable reaches the critical value.
36. A method according to any one of claims 19 to 35, wherein the residual volume is substantially zero before the first cycle of the treatment.
37. A method according to any one of claims 19 to 36, wherein the residual volume is substantially zero after the last cycle of the treatment.
38. A method for carrying out a tidal peritoneal dialysis treatment of a patient in a plurality of cycles, each cycle including a fill period, a dwell period and drain period, the method including for substantially all cycles steps of:
a) determining a first parameter concerning a desired target volume of the dialysis fluid to be contained in an abdominal cavity of the patient after each fill period of the treatment;
b) determining a second parameter concerning a total volume of a dialysis fluid to be used during a remaining part of the treatment;
c) determining a third parameter concerning a total length of time of the remaining part of the treatment;
d) determining a fourth parameter concerning a residual volume of dialysis fluid in the abdominal cavity after the drain period;
e) calculating for the next one of said cycles by means of the parameters a fill volume of the dialysis fluid and a fill/dwell time including the time of the fill period and the dwell period;
f) filling the abdominal cavity of the patient with the calculated fill volume of the dialysis fluid until the target volume is reached;
g) draining the abdominal cavity after the calculated fill/dwell time;
h) sensing during the draining a variable related to the draining of the dialysis fluid leaving the abdominal cavity;
i) interrupting the draining when the variable reaches a breakpoint at which the variable is radically changed; and j) leaving a residual volume of dialysis fluid in the abdominal cavity.
a) determining a first parameter concerning a desired target volume of the dialysis fluid to be contained in an abdominal cavity of the patient after each fill period of the treatment;
b) determining a second parameter concerning a total volume of a dialysis fluid to be used during a remaining part of the treatment;
c) determining a third parameter concerning a total length of time of the remaining part of the treatment;
d) determining a fourth parameter concerning a residual volume of dialysis fluid in the abdominal cavity after the drain period;
e) calculating for the next one of said cycles by means of the parameters a fill volume of the dialysis fluid and a fill/dwell time including the time of the fill period and the dwell period;
f) filling the abdominal cavity of the patient with the calculated fill volume of the dialysis fluid until the target volume is reached;
g) draining the abdominal cavity after the calculated fill/dwell time;
h) sensing during the draining a variable related to the draining of the dialysis fluid leaving the abdominal cavity;
i) interrupting the draining when the variable reaches a breakpoint at which the variable is radically changed; and j) leaving a residual volume of dialysis fluid in the abdominal cavity.
Applications Claiming Priority (5)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| SE0302698A SE0302698L (en) | 2003-10-13 | 2003-10-13 | Device for performing a peritoneal dialysis treatment |
| SE0302698-6 | 2003-10-13 | ||
| US52333403P | 2003-11-20 | 2003-11-20 | |
| US60/523,334 | 2003-11-20 | ||
| PCT/SE2004/001467 WO2005035023A1 (en) | 2003-10-13 | 2004-10-13 | A device for carrying out a peritoneal dialysis treatment |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CA2536421A1 true CA2536421A1 (en) | 2005-04-21 |
| CA2536421C CA2536421C (en) | 2012-03-13 |
Family
ID=34437067
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA2536421A Active CA2536421C (en) | 2003-10-13 | 2004-10-13 | A device for carrying out a peritoneal dialysis treatment |
Country Status (10)
| Country | Link |
|---|---|
| EP (1) | EP1691863B1 (en) |
| JP (1) | JP4658062B2 (en) |
| KR (1) | KR101112117B1 (en) |
| AT (1) | ATE386557T1 (en) |
| AU (1) | AU2004279280B2 (en) |
| CA (1) | CA2536421C (en) |
| DE (1) | DE602004011981T2 (en) |
| ES (1) | ES2298818T3 (en) |
| PL (1) | PL1691863T3 (en) |
| WO (1) | WO2005035023A1 (en) |
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| US11806456B2 (en) | 2018-12-10 | 2023-11-07 | Mozarc Medical Us Llc | Precision peritoneal dialysis therapy based on dialysis adequacy measurements |
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| US3558343A (en) | 1966-08-18 | 1971-01-26 | Texas Instruments Inc | Dispersion strengthened titanium carbide and method for making same |
| GB1280521A (en) * | 1969-06-28 | 1972-07-05 | Whitely Lang And Neill Ltd | Peritoneal dialysis apparatus |
| US5141493A (en) * | 1990-01-26 | 1992-08-25 | Sarcos Group | Peritoneal dialysis system |
| EP0498382B1 (en) | 1991-02-08 | 1996-11-13 | Alan M. Peabody | Continuous peritoneal dialysis system |
| SE502020C2 (en) * | 1994-02-03 | 1995-07-17 | Gambro Ab | Apparatus for peritoneal dialysis |
| AU695256B2 (en) * | 1994-04-06 | 1998-08-13 | Baxter International Inc. | Method and apparatus for a tidal oscillating pulse peritoneal dialysis |
| SE512266C2 (en) * | 1997-07-09 | 2000-02-21 | Gambro Med Tech Ab | Method and Device for Integrity Testing of a Hose Kit Intended for Use in a Peritoneal Dialysis Cycler |
| WO1999051287A1 (en) * | 1998-04-02 | 1999-10-14 | Debiotech S.A. | Device for peritoneal dialysis and method for using said device |
| US6293921B1 (en) * | 1998-07-06 | 2001-09-25 | Jms Company, Ltd. | Automatic exchanger for peritoneal dialysis |
| SE9903331D0 (en) * | 1999-09-16 | 1999-09-16 | Gambro Lundia Ab | Method and apparatus for sterilizing a heat sensitive fluid |
| JP3828080B2 (en) * | 2003-01-16 | 2006-09-27 | テルモ株式会社 | Peritoneal dialysis machine |
| DE602004032347D1 (en) * | 2003-07-31 | 2011-06-01 | Debiotech Sa | SYSTEM FOR THE IMPLEMENTATION OF LIQUID ADMINISTRATION IN PERITONEAL DIALYSIS |
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- 2004-10-13 JP JP2006535305A patent/JP4658062B2/en active Active
- 2004-10-13 EP EP04775545A patent/EP1691863B1/en active Active
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| DE602004011981T2 (en) | 2009-03-05 |
| JP2007508101A (en) | 2007-04-05 |
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| KR101112117B1 (en) | 2012-02-22 |
| JP4658062B2 (en) | 2011-03-23 |
| EP1691863B1 (en) | 2008-02-20 |
| AU2004279280A1 (en) | 2005-04-21 |
| CA2536421C (en) | 2012-03-13 |
| ATE386557T1 (en) | 2008-03-15 |
| AU2004279280B2 (en) | 2009-11-26 |
| EP1691863A1 (en) | 2006-08-23 |
| DE602004011981D1 (en) | 2008-04-03 |
| ES2298818T3 (en) | 2008-05-16 |
| KR20060128862A (en) | 2006-12-14 |
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